Glucocorticoid-Induced Ketoacidosis in Gestational Diabetes: Sequela of the Acute Treatment of Preterm Labor: A case report

Abstract

Pregnancy induces complex changes in energy metabolism, manifested clinically by insulin resistance, low fasting blood glucose levels, and proneness to ketosis. It is quite unusual for pregnant women who do not have type I diabetes to progress from ketosis to frank ketoacidosis, although this phenomenon is common in larger mammals. In the case described here, glucocorticoid administration in the setting of a prolonged fast triggered a metabolic cascade leading to ketoacidosis in a pregnant woman without type 1 diabetes. Other details of this illustrative case serve to synthesize several disparate observations regarding the pathogenesis of pregnancy ketoacidosis. Physicians should be aware of the potential for rapidly developing ketoacidosis with atypical biochemical and clinical features in pregnant women who are treated with high doses of glucocorticoids.

Ketoacidosis with Hypertriglyceridemia-Induced Pancreatitis in a Patient with Gestational Diabetes: A Case Report

“…As in any other disease associated with pregnancy, acute pancreatitis and ketoacidosis lead to greater concerns as they pose instant serious threat to the life of mother, fetus, or both. There are some reports of hypertriglyceridemia-induced acute pancreatitis in pregnancy [4][5][6][7] and DKA in gestational diabetes [8][9][10]. However, the case described here is ketoacidosis with hypertriglyceridemia-induced pancreatitis in patient with gestational diabetes.…”

Diabetic Ketoacidosis Secondary to L-Asparaginase and Dexamethasone during Treatment for Acute Lymphoblastic Leukaemia

“…The development of ketoacidosis in the setting of glucocorticoids is uncommon but has been previously described [2,4,5]. Alavi et al [2] described the onset of glucocorticoid-induced DKA in 5 patients receiving glucocorticoids for collagen vascular disease.…”

Insulin Resistance in the Third Trimester of Pregnancy Suffering from Gestational Diabetes Mellitus or Impaired Glucose Tolerance

“…The syndrome of insulin resistance is a group of clinically diverse disorders (Catalano, 2010;Flier, 1992). Pregnancy induces complex changes in energy metabolism, manifested clinically by insulin resistance (Bedalov & Balasubramanyam, 1997). Glucose tolerance deteriorates in all pregnant women, but only in 2-3% of all pregnancies is the deterioration sufficiently large to fulfill the diagnostic criteria for gestational diabetes1.…”